Infection Control

how long can influenza survive outside a host

At room temperature, with moderate humidity, these viruses can live 24 to 48 hours on steel and plastic, and 8 to 12 hours on cloth and facial tissues.

antibody

a type of protein the immune system produces to neutralize a threat of some kind, such as an infecting organism, a chemical, or some other foreign body

waste management

Disposing properly of patient-care equipment contaminated with blood, body fluids, secretions, and excretions is essential for preventing the spread of micro-organisms to other patients and environments. Do not use reusable equipment for the care of other patients until it has been cleaned and reprocessed appropriately. Most facilities have procedures in place for the routine care, cleaning, and disinfection of environmental surfaces, beds, bedrails, bedside equipment, and other frequently touched surfaces. Be sure these procedures are being followed. Dispose of sharp instruments such as needles, syringes, and scalpels in a puncture-resistant container. To prevent injuries, never break, recap, bend, or manipulate sharp instruments before disposing of them. Dispose of blood, body fluids, suctioned fluids, and excretions by flushing them into the sewage system or per agency protocol. When dumping potentially infectious fluid, be especially careful not to splash it on your uniform or on the surrounding environment. Dispose of the emptied container in the appropriate receptacle. Consider all specimens potentially infectious, and collect them in a container that closes securely. Avoid contamination of the outside of the container. Most agencies require placing the specimen in a plastic bag labeled as "Biohazard" before transporting. Linens: Handle linens soiled with blood, body fluids, secretions, and excretions carefully, and, to protect other healthcare workers, transport them in a leak-resistant bag. Hold soiled linens away from the body to prevent contamination of clothes. Avoid shaking or tossing linens, as this can spread micro-organisms to other patients and environments. Also, to prevent transmitting infection, do not place soiled linens on the floor. If clean linens touch the floor or any unclean surface, immediately place them in the soiled linen container.

documentation

Documentation is an essential component of patient care. Not only does it provide information about the care you give and the status of your patient, but it also communicates information to other healthcare workers to help assure both quality and continuity. Additional uses of documentation include: use in legal proceedings, reimbursement, education, research, and quality assurance. The format used for documentation varies from agency to agency, so be sure to familiarize yourself with your agency's format and follow it. Use only approved abbreviations and make sure all documentation is clear, concise, and legible. Maintain privacy and confidentiality of patient information at all times. Mandatory compliance with the privacy rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was introduced in 2003 to help ensure that patient information is kept confidential and to give patients more control over their personal healthcare information and who has access to it. HIPAA originally required written consent for disclosure of all patient information. Because this sometimes delayed the process of giving patients timely care, the act was revised. Now healthcare providers are only required to notify patients of their privacy policy and to make a reasonable effort to obtain written acknowledgment of this notification. All healthcare providers, including students, have a legal and ethical obligation to follow HIPAA regulations. In clinical settings, students should only gather the information from the patient's medical record that they need to provide safe and efficient care. Any written material students prepare and share, submit, or distribute must exclude the patient's name, room number, date of birth, medical record number, and any other identifiable demographic information. Types of documentation Documentation for infection control should include the following and any additional information pertinent to a procedure: infection control measures used clean or sterile gloves used if the patient has a latex sensitivity or allergy the patient's response to care any specimens and cultures obtained and sent to lab disposal precautions used

are artificial nails acceptable in health care facilities?

Evidence shows that healthcare workers wearing artificial nails carry more pathogens on their nails than other health care workers. The effectiveness of hand hygiene is reduced. The Centers for Disease Control and Prevention, the Joint Commission, and the American Association of Operating Room Nurses recommend prohibiting the wearing of artificial nails.

cough etiquette

In 2013, the Centers for Disease Control recommended that respiratory hygiene/cough etiquette be incorporated into infection control as one component of standard precautions. These should be instituted in the health care setting at the first point of contact with a potentially infected person to prevent the transmission of all respiratory infections. The recommended practices have a strong evidence base. Respiratory hygiene/cough etiquette applies to anyone entering a healthcare setting: patients, visitors, and staff with signs or symptoms of illness, whether diagnosed or undiagnosed, including cough, congestion, rhinorrhea, or increased production of respiratory secretions. The components of respiratory hygiene/cough etiquette include: covering the mouth and nose during coughing and sneezing using facial tissues to contain respiratory secretions, with prompt disposal into a hands-free receptacle wearing a surgical mask when coughing to minimize contamination of the surrounding environment turning the head when coughing and staying at least 3 feet away from others, especially in common waiting areas disinfecting hands after contact with respiratory secretions Be sure to educate patients and families about these new guidelines. Also, be sure to observe standard and droplet precautions and hand hygiene when examining and caring for patients with signs and symptoms of a respiratory infection. It is also a good idea to post signs in languages appropriate for the population served, with instructions to patients and accompanying family members or friends reminding them of these recommendations.

how far can a virus-laden droplet travel and still be a potential source of infection?

It can travel up to 3 feet in any direction and still be infectious.

Latex and latex free equipment

Latex sensitivity and latex allergies are of concern to healthcare workers and patients. This is partly due to the potential for high exposure to latex gloves and medical supplies that contain latex. Healthcare workers and patients who have a sensitivity or allergy to kiwifruit, papayas, avocados, bananas, potatoes, or tomatoes should be screened carefully as they have a higher chance of having a sensitivity or allergy to latex. The three most common reactions to latex products are: Irritant contact dermatitis Allergic contact dermatitis (delayed hypersensitivity) Latex allergy Irritant contact dermatitis Rubber latex products often cause irritant contact dermatitis. Areas of the skin, usually the hands, become dry, itchy, and irritated. This reaction is caused by skin irritation from using gloves and possibly by exposure to other workplace products and chemicals. The reaction can also result from repeated handwashing and drying, incomplete hand drying, use of cleaners and sanitizers, and exposure to powders added to the gloves. Irritant contact dermatitis is not a true allergy. Chemical-sensitivity dermatitis Allergic contact dermatitis results from exposure to chemicals added to latex during harvesting, processing, or manufacturing. These chemicals cause skin reactions similar to those caused by poison ivy. The rash usually begins 24 to 48 hours after contact and may progress to oozing skin blisters or spread away from the area of skin touched by the latex. Latex allergy The most serious reaction to latex is a latex allergy. The protein in rubber can cause an allergic reaction in some people. It can be a more serious reaction to latex than irritant contact dermatitis or allergic contact dermatitis. Also, when healthcare workers change gloves, the protein/powder becomes airborne and could be inhaled into the respiratory tract. Reactions usually begin within minutes of exposure to latex, but they can occur hours later and can produce various symptoms. Mild reactions to latex involve skin redness, hives, and itching. More severe reactions may involve symptoms such as runny nose, sneezing, itchy eyes, scratchy throat, and asthma (difficult breathing, coughing spells, and wheezing), and anaphylactic shock. Treating latex allergy Once a healthcare worker or patient has been identified with a latex sensitivity or allergy, precautions must be taken to prevent exposure. Replacing latex-containing gloves and supplies with non-latex items is essential. Preventing a latex allergy Use non-latex gloves for activities that do not involve exposure to infectious materials. Request non-latex gloves that provide protection against infectious materials. Avoid oil-based creams or lotions while using latex gloves. This may cause break down of the gloves. Wash hands with a mild soap, and dry hands completely after using gloves. Request reduced-protein, powder-free gloves if your facility supplies latex gloves. Recognize symptoms of a latex allergy. When a patient has been identified with a latex sensitivity or allergy, it is important that the entire healthcare team be aware. A latex-free cart supplied with latex-free items should be used for all care to prevent exposing the patient to latex.

how long can fingernails be?

Nails should extend no more than ¼ inch past the nail bed. Special care should be taken to clean the underside thoroughly. Artificial nails should be avoided.

Are prescription eyeglasses or contact lenses acceptable form of eye protection?

No. Neither eyeglasses nor contact lenses provide enough coverage to prevent infectious disease (splashes) via ocular exposure and transmission.

when without a handkerchief or a facial tissue, is it appropriate to "sneeze into your sleeve"

Oddly enough, yes, this reduces the transmission of airborne infection.

personal protective equipment

Personal protective equipment (PPE) such as gloves, gowns, masks, and eyewear may be necessary to avoid contact with blood, body fluids, secretions, and excretions and the transmission of infectious material found in these substances. Gloves Wear clean, nonsterile gloves when touching blood, body fluids, secretions, excretions, and contaminated items, including respiratory secretions, and when providing oral care or handling soiled tissues. Also, use clean gloves just before touching mucous membranes and non-intact skin. Gloves should fit comfortably and not be reused. The use of gloves does not eliminate the need for hand hygiene. Likewise, the use of hand hygiene does not eliminate the need for gloves. 1)Perform hand hygiene until the product disappears and the hands are dry. 2)Select the appropriate size glove. 3)Holding the glove at the opening, slip the fingers into the glove and pull tight. 4)With the gloved hand, hold the second glove at the opening and slip the ungloved fingers into the glove and pull tight. 5)Pull gloves to the wrists of both hands. 6)Remove the gloves by grasping the cuff of the other gloved hand. 7)Avoiding skin contact, roll the glove inside out and place it in the palm of the gloved hand. 8)Grasp the glove on the inside of the cuff and pull inside out. 9)Dispose of the gloves. 10)Perform hand hygiene. Change gloves between tasks and procedures on the same patient after contact with material that may contain a high concentration of micro-organisms. Remove gloves promptly after use, before touching non-contaminated items and environmental surfaces, and before going to another patient, and wash hands immediately to avoid transferring micro-organisms to other patients or environments. Wear sterile gloves when following the principles of surgical asepsis for keeping an area/object free of all micro-organisms. Thorough handwashing must be performed before donning sterile gloves and after discarding the gloves. Detailed guidelines for the use of sterile gloves are found in the module entitled, Surgical Asepsis. Masks Masks provide barriers to infectious materials and are often used with other personal protective equipment such as gowns and gloves. When worn properly, masks and eye protection provide protection for the mouth, nose, and eyes during procedures where there is a potential for droplets or splashing of blood or body fluids. In addition to these standard precautions, special precautions are mandated by the CDC for airborne, droplet, and contact involving highly transmissible diseases such as measles, varicella, tuberculosis, influenza, mumps, rubella, wound infections, scabies, and many other infectious diseases. Procedure masks are flat/pleated and affix to the head with ear loops. They are used for any nonsterile procedure. Surgical masks come in two basic types: One type is affixed to the head with two ties, conforms to the face with the aid of a flexible adjustment for the bridge of the nose, and may be flat/pleated or duck-billed in shape. The second type of mask is pre-molded, adheres to the head with a single elastic band, and has a flexible adjustment for the bridge of the nose. All masks have some degree of fluid resistance, but those approved as surgical masks must meet specified standards for protection from penetration of blood and body fluids. 1)Some masks have ties and some have elastic to secure the mask to the face. One is flexible and one is molded. 2)Both have a flexible nose piece that is adjusted by pinching at the bridge of the nose. 3)Place and hold the mask over the nose, mouth, and chin while stretching the band over the ear or tying the ties behind the head and at the base of the neck. 4) Adjust the mask so it is snug with no gaps. The mask should not be touched or readjusted during use 5)After properly removing and disposing of gloves, carefully remove the elastic from the ear or untie the mask from the back of the head, bottom tie first. 6) Dispose of the mask 7)Perform hand hygiene Respirators Respirators are used for case-specific procedures where particulates and secretions create a high risk of infection for the healthcare worker. Agencies typically have special procedures for these devices and provide special training and clearance for use. Current OSHA standards require that respirators used for airborne precautions for suspected and confirmed pulmonary tuberculosis (TB) minimally filter 95% of 0.3 µm-size particles. The N95 respirator and the HEPA respirator meet these requirements. All personnel who care for patients with suspected and confirmed pulmonary TB must wear an N95/HEPA respirator when entering the patient's room. An N95 respirator mask is intended to be used for protection against solids. The N95 is extremely durable and has a soft and comfortable inner surface, an adjustable nosepiece, and secure headstraps to provide proper fit. A person using an N95/HEPA respirator must be fit-tested before use. Check with agency policy about respirator use for infection control. Face and eye protection Face and eye protection provide a barrier to infectious substances and are typically used in conjunction with other personal protective equipment such as gloves, gowns, and masks. The type of face and eye protection chosen depends on the specific work conditions and potential for exposure. There are a variety of devices including goggles, shields, safety glasses, and even full-face respirators. Personal knowledge of potential exposure is essential for making an informed decision about the right face and eye protection. Eyeglasses prescribed for vision correction and contact lenses are not considered eye protection. For complete and proper protection, it's also important to evaluate the combination of protection recommended for the specific work situation. For example, some masks may not work with various goggles or shields. Likewise, a full-face respirator may provide adequate protection without additional personal protective equipment. 1)Grasping the ear or head pieces of the appropriate device, spread and slowly apply the device over the ears. 2)Adjust for comfort as needed 3)Using ungloved hands, grasp the ear pieces and lift away from the face. 4)Discard disposable devices in the appropriate receptacle. If the device is designed to be reused, process it according to agency protocol. Goggles Goggles are available with direct or indirect venting. Direct-vented goggles have the potential for allowing the penetration of splashes and are not as reliable as indirect-vented goggles. Goggles must fit snugly to provide adequate protection from splashes, sprays, and respiratory droplets. Face shields Face shields are sometimes used as an alternative to goggles. Because the shield has a larger surface area, it provides protection to other facial areas. Face shields do not fit snugly against the face, making them vulnerable to splash and spray going under the shield. Shields are typically used with other forms of protection and should not be considered the best protection. Safety glasses Safety glasses are excellent for providing impact protection. However, they do not protect adequately from splash, spray, and respiratory droplets. Thus, they are not typically used for infection-control purposes. Gowns A clean, nonsterile gown is adequate for protecting skin and preventing soiling of clothing during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. Most patient interactions do not require the use of a gown. Select a gown that is appropriate for the activity and amount of fluid likely to be encountered. Remove a soiled gown as promptly as possible and wash hands to avoid transferring micro-organisms to other patients or environments. 1)Select the appropriate type and size of gown. 2)With the gown opening in the back, pull the arms through the sleeves one at a time and pull it over the shoulders. Secure at the neck and waist. 3)If the gown is disposable and designed to be removed quickly, the gloves may be removed with the gown and rolled together to prevent contamination. 4)If not using a breakaway gown, untie the waist tie before removing the gloves. Remove gloves and with ungloved hands, untie the gown at the neck and pull it away from the shoulders. Roll it into a bundle while avoiding contact with the outside of the gown. 5)Dispose of the gown. 6) Perform hand hygiene

standard and transmission based precautions

Standard precautions Standard precautions are applied to the care of all patients in all healthcare settings, regardless of suspected or confirmed presence of an infectious agent. Standard precautions are used with blood, blood products, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes. This includes infection prevention practices that apply to all patients: hand hygiene; use of gloves, gown, mask, and face shield; respiratory hygiene/cough etiquette; and safe injection practices. The practice is determined by the extent of anticipated blood, body fluid, or pathogen exposure. Transmission-based precautions The second tier addresses isolation precautions, which are based on the mode of transmission of a disease. There are three categories of transmission-based precautions: contact precautions, droplet precautions, and airborne precautions. These are used when the route of transmission is not completely interrupted by standard precautions. Transmission-based precautions are for patients who have highly transmissible pathogens. Contact precautions Direct contact refers to the care and handling of contaminated body fluids. Indirect care refers to the transfer of an infectious organism through a contaminated intermediate object, such as contaminated instruments or hands of healthcare workers. Contact precautions include the use of personal protective equipment: gloves and gowns. These patients should also be in a private room to prevent cross-contamination. Examples of infections contact precautions are instituted for include VRE, MRSA, C. difficile, wound infections, and herpes simplex. Droplet precautions Droplet precautions are used when a disease is transmitted by large droplets expelled into the air and travels 3 to 6 feet from the patient. This type of precaution requires the use of a surgical mask when within 3 feet of the patient, proper hand hygiene, and some dedicated care equipment. The mask should be applied prior to entering the patient's room. Examples of a patient who requires droplet precautions include those who have influenza or Mycoplasma pneumonia. Airborne precautions Airborne precautions are used with patients who have diseases that are transmitted by smaller droplets. These droplets remain airborne for longer periods of time. This form of isolation requires a negative airflow. This airflow filters air through a high-efficiency particulate air (HEPA) filter and then directs the air to the outside of the facility. This type of precaution requires the use of an N95 respirator each time healthcare workers enter the patient's room. This mask should be applied prior to entering the room. This type of mask must be fitted properly prior to use. An example of a diagnosis that requires airborne precautions is pulmonary tuberculosis. With all of these types of transmission-based precautions, certain basic principles should be followed. Thorough perform hand hygiene prior to entering and leaving the room of a patient in isolation. Properly dispose of contaminated supplies and equipment according to agency policy. Apply knowledge of mode of infection transmission when using personal protective equipment. Protect all persons from exposure during transport of an infected patient outside of the isolation room. Protective Environment The protective environment is designed for patients who have undergone transplants and gene therapy. This environment reduces the risk of environmental fungal infections. These patients require a private room with positive airflow and HEPA filtration for incoming air. The patient should wear a mask if they are out of the room during times of construction in the area. They are also not allowed to have fresh flowers or potted plants in their rooms.

how can I protect elderly clients and other immunocompromised clients from health care associated infections?

Standard precautions should be used with all patients to prevent the spread of pathogens.

Do handwashing behaviors change when gloves are used?

The authors concluded that a focus on limiting glove use to high-risk contacts with hand hygiene before and after such contacts may increase overall hand hygiene compliance.

Is there a difference between alcohol-based foam, gel, and hand wipe products in removing influenza A (H1N1) virus?

The authors concluded that alcohol-based foam, gel, or wipes provided significant reductions in viral counts on hands.

What type of organizational strategies can be used to reduce sharps including needlestick injuries and adherence to universal precautions?

The authors suggest several organizational strategies to improve a culture of sharps safety and safe practices, including a reporting process of SIN injuries, designation of a person/department responsible for responding to SIN injuries, and safety training that emphasizes recapping as an unsafe work practice.

Does an evidence-based approach to changing hand hygiene practices affect infection rates?

The multi-faceted approach to the hand hygiene initiative was associated with a significant improvement in hand hygiene practice that was sustained through the following year. In addition, a sustained reduction in the incidence of healthcare-associated infection was reported.

What strategies are effective in improving adherence to hand hygiene procedures?

The multi-faceted training intervention for improving hand hygiene and gloving practices had a significant effect on adherence with recommendations when the outcome was analyzed 1 year after program initiation.

antiseptic

a substance that reduces the number of pathogens present on a surface

Are there differences in the efficacy of various alcohol-based hand hygiene solutions?

The researchers found that the 70% gel and foam hand rub formulations met American and European efficacy standards. A 2 mL volume of these formulations as effective in reducing bacterial contamination, whereas the other products did not meet American standards at a lower volume. The authors concluded that product formulation can significantly influence the antimicrobial efficacy of alcohol-based hand rubs and is more important than alcohol concentration alone.

What are the factors that influence noncompliance with hand hygiene procedures?

The study identified many important factors that may be targeted during hand hygiene initiatives, including hand hygiene education and training for medical staff, a focus on daytime shifts, pediatric units, and reminders for hand hygiene prior to initial patient contact. The location and ease of access to alcohol-based hand rub dispensers was also noted as a modifiable factor.

hand hygiene

The term "hand hygiene" refers to both handwashing with an antimicrobial or plain soap and water as well as alcohol-based products such as gels, foams, and rinses. Alcohol-based products contain an emollient that does not require the use of water. According to the most up-to-date infection-control guidelines from the Centers for Disease Control and Prevention, in the absence of visible soiling of hands and when contamination from spore-forming organisms such as Clostridium difficile is unlikely, approved alcohol-based products for hand disinfection are preferred over antimicrobial or plain soap and water because of their superior microbicidal activity, reduced drying of the skin, and convenience. Overall, hand hygiene remains the most important measure for preventing the transmission of micro-organisms. Upon arrival to work, inspect the surface of your hands for breaks or cuts in the skin or cuticles. If lesions are found, apply dressing prior to providing care to patients. Perform hand hygiene before caring for a patient and after contact with anything in the room. Perform hand hygiene after touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn. Perform hand hygiene immediately after gloves are removed, between patient contacts, and when otherwise indicated to avoid transfer of micro-organisms to other patients or environments. It may be necessary to perform hand hygiene between tasks and procedures on the same patient to prevent cross-contamination of different body sites. Avoid artificial nails, which harbor micro-organisms, and keep nails trimmed to one quarter of an inch when caring for patients. In addition, avoid wearing rings whenever possible. If the areas under fingernails are soiled, clean them with the fingernails of the other hand or with an orangewood stick. Wash hands with soap and water when hands are visibly soiled. Soap and water handwash 1) turn on the water and adjust it to a comfortable, warm temp. 2) Wet the hands, keeping the hands lower than the elbows. 3) Apply 3 to 5 mL of soap to the hands, coating all surfaces. 4)Rub the hands vigorously together, working up a lather, for at least 15 seconds. 5)Rinse thoroughly, pointing the fingers down to allow water to run off the hands. 6)Dry the hands from the fingers to the wrist. 7)Turn off the water with a clean paper towel. alcohol-based handrub 1)Apply 3 to 5 mL (per manufacturer) of antiseptic gel to the palm of one hand. 2)Rub the hands together, coating all surfaces, and rub vigorously until the gel disappears and the hands are dry. 3)apply gloves

staphylococcus

a genus of gram-positive bacteria that are potential pathogens, causing local lesions and serious opportunistic infections

latex

a milky fluid produced by rubber trees that is processed into a variety of products, including gloves used for patient care

methicillin-resistant Staphylococcus aureus (MRSA)

a strain of the bacterium Staphylococcus aureus that has become resistant to the antibacterial action of the antibiotic methicillin, a form of penicillin

vancomycin-resistant Staphylococcus aureus (VRSA)

a strain of the bacterium Staphylococcus aureus that has become resistant to the antibacterial action of the antibiotic vancomycin

antimicrobial

able to destroy or suppress the growth of pathogens and other micro-organisms

chlorhexidine

an antibacterial compound with substantial residual activity that is used as a liquid antiseptic and disinfectant

disinfectant

any chemical agent used to destroy or inhibit the growth of harmful organisms

pathogen

any disease-producing agent, especially a virus, bacterium, or fungus

retrovirus

any of a large group of RNA-based viruses that tend to infect immunocompromised individuals, including the human immunodeficiency virus and many cancer-causing viruses

aseptic

as pathogen-free as possible

hyperendemic

at an especially high level of continued incidence in a population

personal protective equipment (PPE)

devices used to protect employees from workplace injuries or illnesses resulting from biological, chemical, radiological, physical, electric, mechanical, or other workplace hazards

exogenous

externally caused rather than produced within an organism or system

epidemic

extremely prevalent or widespread

medical asepsis

infection-control practices common in healthcare, such as basic handwashing

infection

invasion and proliferation of pathogens in body tissues

standard precautions

measures designed to prevent the transmission of organisms and used for all patients in healthcare facilities regardless of diagnosis or infection status

transmission-based precautions

measures taken to prevent the spread of diseases from people suspected to be infected or colonized with highly transmissible pathogens that require measures beyond standard precautions to interrupt transmission, specifically, airborne, droplet, and contact precautions

contact precaustions

measures taken to prevent the spread of diseases transmitted by the physical transfer of pathogens to a susceptible host's body surface

droplet precautions

measures taken to prevent the spread of diseases transmitted from an infected person by pathogens propelled through the air on particles larger than 5 µm in size to a susceptible person's eyes, nose, or mouth

airborne precautions

measures taken to prevent the spread of diseases transmitted from an infected person by pathogens propelled through the air on particles smaller than 5 µm in size to a susceptible person's eyes, nose, or mouth

asepsis

methods used to assure that an environment is as pathogen-free as possible

pneumococcal

pertaining to or caused by pneumococci, organisms of the species Streptococcus pneumoniae, a common cause of pneumonia and other infectious diseases

endemic

prevalent in or characteristic of a particular environment

endogenous

produced within an organism or system rather than externally caused

surgical asepsis

techniques used to destroy all pathogenic organisms, also called sterile technique

flora

the aggregate of bacteria, fungi, and other micro-organisms normally found in a particular environment, such as the gastrointestinal tract or the skin

bacteriostasis

the inhibition of further bacterial growth

immunosuppression

the inhibition of the body's protective response to pathogenic invasion, usually as a result of disease, drug therapy, or surgery

sepsis

the presence in blood or other tissues of pathogens or their toxins

contamination

the process of becoming unsterile or unclean

isolation

the separation of an infected person from others for the period of communicability of a particular disease